NHM offers Incentives, Honorariums to encourage doctors to practice in Rural Areas: MoS Health
New Delhi: To encourage specialist doctors to practice in rural and remote areas, various incentives and honorariums are offered under the National Health Mission. However, the responsibility for filling vacant doctor positions in medical colleges lies with the state governments, Union Minister of State Health and Family Welfare Shri Prataprao Jadhav informed Lok Sabha recently.
According to MoS Health, a hard area allowance and residential quarters are provided to doctors so that they find it attractive to serve in public health facilities in rural and remote areas. Additionally, honorariums are provided to Gynecologists, Pediatricians, and Anesthetists trained in Emergency Obstetric Care (EmOC) or Life-Saving Anesthesia Skills (LSAS) to enhance the availability of specialists for performing Cesarean sections in these underserved areas.
Incentives like specific rewards for doctors and incentives for Auxiliary Nurse Midwives (ANMs) are provided to encourage timely Antenatal Care (ANC) checkups and documentation, along with incentives for conducting Adolescent Reproductive and Sexual Health initiatives.
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"States are also allowed to offer negotiable salaries to attract specialists including flexibility in strategies such as “You Quote We Pay”. Non-monetary incentives such as preferential admission in postgraduate courses for staff serving in difficult areas and improving accommodation arrangements in rural areas have also been introduced under NHM. Multi-skilling of doctors is supported under NHM to overcome the shortage of specialists. Skill upgradation of existing HR is another major strategy under NRHM for achieving improvement in health outcomes," said the Minister.
The Union Minister of Health and Family Welfare Shri Prataprao Jadhav shared this information with the Lok Sabha while responding to some queries in this regard. Parliament members Shri Radheshyam Rathiya and Shri Devesh Shakya sought to know from the Ministry about any steps/proposes taken to fill up the large number of vacant posts of doctors in district hospitals and medical colleges across the country, if so, the details thereof, State/UT-wise, particularly in Saifai, Etah, Kasganj, Etawah, Auraiya, Kannauj and other districts of Uttar Pradesh and Chhattisgarh.
Further, the Ministry was asked to provide the time by which the vacant posts are likely to be filled, and the steps taken or proposed to be taken by the Government to address the issue of lack of equipment, infrastructure and basic facilities in medical colleges across the country including Chhattisgarh and Uttar Pradesh, whether the medicines being given to patients are available in sufficient quantities in these districts and if so, the details thereof.
Besides, other queries included whether the schemes being implemented for the prevention of communicable diseases are adequate, if so, the details thereof; and whether the benefits of these schemes are reaching to people, if so, the details thereof and if not, the reasons therefor.
Responding to these queries, the Union Health Minister informed that "All the administrative and personnel matters related to health human resource lies with the respective State/UT Governments. Under National Health Mission, Ministry of Health & Family Welfare provides financial and technical support to States/UTs to strengthen their healthcare systems based on the requirements posed by them in their Programme Implementation Plans (PIPs) within their overall resource envelope. The Medical Colleges mainly come under administrative control of State Governments and vacant positions in these colleges are filled up by state governments."
Further, the Minister informed that the State/UT-wise details of Doctors in district hospitals including the States of Uttar Pradesh and Chhattisgarh are available at the website of the Ministry of Health and Family Welfare.
The Ministry of Health & Family Welfare implements Centrally Sponsored Schemes (CSS) to enhance medical education by upgrading State and Central Government medical colleges, aiming to increase MBBS and PG seats across the country.
The Minister informed that these schemes provide financial support for civil works, equipment, and furniture, with a cost ceiling of Rs 1.20 crore per seat. The funding is shared between the Centre and State Governments in a 90:10 ratio for North Eastern and Special Category States, and 60:40 for other states.
Under the CSS for upgrading medical colleges to increase MBBS seats, 83 Government Medical Colleges across 17 states have been approved, adding 4,977 MBBS seats, including 432 in Uttar Pradesh and 150 in Chhattisgarh. Similarly, the CSS for strengthening and upgrading medical colleges to introduce new PG disciplines and increase PG seats has approved 8,058 additional seats in two phases, including 556 in Uttar Pradesh and 79 in Chhattisgarh, the minister shared the data with the parliament.
To ensure the availability of essential drugs, the MoS said that the Government has rolled out the Free Drugs Service Initiative (FDSI) under the National Health Mission (NHM). Under this, financial support is provided to States / UTs for the provision of free essential medicines in public health facilities based on the requirements posted by them in their Programme Implementation Plans (PIPs) within their overall resource envelope.
"Support under the scheme is available for Procurement of drugs and strengthening/setting up robust systems of procurement, Quality Assurance, Supply chain management and warehousing, Prescription audit, grievance redressal, dissemination of Standard Treatment Guidelines and Establishment of IT enabled platform DVDMS (Drugs & Vaccine Distribution Management System) for monitoring the real status of procurement and availability of essential medicines," he added.
When asked about the schemes being implemented for the prevention of communicable diseases, the Minister informed that Health is a state subject. Ministry of Health & Family Welfare provides technical and financial support to States/UTs through various schemes including the national Vector Borne Diseases Control Programme (NVBDCP), National TB Elimination Programme (NTEP), National Leprosy Eradication Programme (NLEP) and the National Viral Hepatitis Control Programme (NVHCP) under the aegis of National Health Mission (NHM) to prevent and control various communicable diseases.
Some of the key outcomes of the programmes are as follows:
- There is a 79.35% and 85.07% reduction in malaria cases and deaths respectively in the year 2023 as compared to 2014.
- The percentage of Kala Azar endemic blocks, achieving the elimination target of < 1 KA case per 10,000 population is 100% at the end of 2023.
- The National target of sustaining case fatality rate (CFR) to less than 1 percent for Dengue was achieved.
- The incidence of Tuberculosis per 1,00,000 population has reduced from 237 in 2015 to 195 in 2023 and mortality rate declined from 28 in 2015 to 23 in 2023 as per the Global TB Report.
- The number of districts with a prevalence of Leprosy less than 1 per 10,000 population has increased from 542 in 2014-15 to 634 districts in 2023-24.
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